Provider Demographics
NPI:1528480076
Name:SOUTH ATLANTA AMBULATORY SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:SOUTH ATLANTA AMBULATORY SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRESSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-779-6135
Mailing Address - Street 1:830 EAGLES LANDING PKWY
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7366
Mailing Address - Country:US
Mailing Address - Phone:402-779-6135
Mailing Address - Fax:866-760-3757
Practice Address - Street 1:830 EAGLES LANDING PKWY
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7366
Practice Address - Country:US
Practice Address - Phone:402-779-6135
Practice Address - Fax:866-760-3757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical